28 september 2012

Low-income countries face high burden of epilepsy

Source: The Lancet and Wellcome Trust

Health

MRI scan of human brain.
Epilepsy can be caused by damage or disruption to the brain.

The number of people with epilepsy in poorer countries is more than double that in higher-income nations, a study by researchers from Oxford University and the Instituto Nacional de Ciencias Neurologicas in Peru has found.

The high number of people with epilepsy is likely to be down to the higher incidence of head trauma, poor neonatal care, and infections such as pork tapeworm and river blindness in these regions – all of which are risk factors for epilepsy.

More than 60% of people in these regions are not accessing any appropriate epilepsy treatment, the study suggests. Huge barriers to accessing care remain, particularly in rural areas, yet epilepsy is one of the most cost-effective disorders to treat.

The burden of epilepsy in poorer parts of the world could be readily alleviated by reducing the preventable causes of the condition and improving access to treatment, the researchers say.

They call for greater recognition from international and national health agencies to address the management of epilepsy in low- and lower-middle-income countries.

Many people with epilepsy do not know that they have a disorder that can be controlled with treatment.

Professor Charles Newton

Lead author Professor Charles Newton of the Department of Psychiatry at Oxford University, who works in Wellcome Trust programmes in Tanzania and Kenya, said: 'Epilepsy needs to be brought into the agenda of non-communicable diseases. It was not mentioned in the UN General Assembly Meeting in New York to address the global burden of non-communicable diseases, and yet it represents a substantial burden of ill health.'

Professor Newton and Professor Hector Garcia, from the Instituto Nacional de Ciencias Neurologicas, conducted a comprehensive review of academic articles about epilepsy in low-income countries to piece together a picture of the burden of the disease in poorer parts of the world.

Professor Newton said: 'The burden of epilepsy in these regions is at least double that found in high-income countries, and sadly, adequate facilities for diagnosis, treatment and ongoing management of epilepsy are virtually non-existent in many of the world's poorest regions.

'Many people with epilepsy or their families do not even know that they have a disorder that can be controlled with biomedical treatment, so it is vitally important that awareness is raised and medical care improved in these regions.'